两膝之痘独稠密，因地命名为抱膝，须防行浆难下达，速用松肌通圣治。
【注】抱膝者，遍身痘出稀疏，独两膝攒簇如饼。此毒瓦斯凝聚于膝，至行浆时恐难下，
达于足胫也。宜用松肌通圣散加牛膝透之，功效甚速。
\r抱膝图\p03-b24a20.bmp\r
松肌通圣散（方见蒙头证治）
足踝以下痘无形，毒热锢蔽势多凶，速宜驱毒扶脾气，快 越婢汤有功。
【注】足踝以下属于脾经，若周身有痘而此地独无者，名曰无根，是毒滞于脾也。但
足为至阴之地，非创建中州，发越脾气，不能下达，故用快 越婢汤以发之。
\r无根图\p03-b24a21.bmp\r
快 越婢汤
黄 （蜜制） 桂枝 防风 白芍药（炒） 甘草（生）
引用生姜、红枣，水煎服。
【方歌】快 越婢药最灵，黄 桂枝及防风，白芍甘草姜枣引，煎服之后痘自生。
蛇皮痘出似蛇皮，隐隐簇簇漫无拘，毒轻归宗汤调治，毒重必胜猪尾宜。
【注】痘出丛簇成片，散漫无拘，名曰蛇皮。见点之初，视其隐隐簇簇，细密无伦，乃
毒火所致。以归宗汤攻其毒，甚者以必胜汤佐以猪尾膏救之。
\r蛇皮图\p03-b24a22.bmp\r
归宗汤（方见发热证治）
必胜汤（方见见点证治）
猪尾膏（方见锁唇证治）
The pustules on both knees are exceptionally dense; named "Embracing Knees" (Bao Xi) due to their location, one must guard against difficulty in the downward movement of pus during the suppuration stage and promptly use Songji Tongsheng San (Loosen Muscle Supreme Holy Powder).
[Note] "Embracing Knees" refers to a condition where pustules are sparse over the entire body but cluster densely around both knees like a cake. This is because toxic qi has condensed at the knees, and during the suppuration stage, it may fail to descend to the shins and feet. It is appropriate to use Songji Tongsheng San (Loosen Muscle Supreme Holy Powder) with added Achyranthis Bidentatae Radix (Niuxi, 牛膝) to facilitate penetration, yielding rapid efficacy.
Below the ankles, there is an absence of pustule morphology; the obstruction by toxic heat indicates a generally ominous prognosis. One should promptly expel toxins and support Spleen Qi; Kuai Fei Bi Tang (Rapidly Overcoming Maclaw Decoction) will be effective.
[Note] The area below the ankles belongs to the Spleen Meridian. If pustules appear all over the body but are absent here, it is called "Rootless" (Wu Gen), indicating that toxic stagnation resides in the Spleen. Since the foot is a place of extreme Yin, without establishing the Middle Jiao and venting Spleen Qi, the toxin cannot descend. Therefore, Kuai Fei Bi Tang (Rapidly Overcoming Maclaw Decoction) is used to disperse it.
Kuai Fei Bi Tang (Rapidly Overcoming Maclaw Decoction)
Astragali Radix (Huangqi, 黄芪) (honey-processed) Cinnamomi Ramulus (Guizhi, 桂枝) Saposhnikoviae Radix (Fangfeng, 防风) Paeoniae Radix Alba (Baishao, 白芍药) (stir-fried) Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) (raw)
Use Zingiberis Rhizoma Recens (Shengjiang, 生姜) and Jujubae Fructus (Dazao, 红枣) as guides, decoct in water and take orally.
[Prescription Verse] Kuai Fei Bi Tang (Rapidly Overcoming Maclaw Decoction) is most efficacious, containing Astragali Radix (Huangqi, 黄芪), Cinnamomi Ramulus (Guizhi, 桂枝), and Saposhnikoviae Radix (Fangfeng, 防风); with Paeoniae Radix Alba (Baishao, 白芍药), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草), Ginger (Shengjiang, 生姜), and Jujube (Dazao, 红枣) as guides, after decoction and oral administration, the pustules will naturally emerge.
Snake-skin pustules resemble snake skin, appearing faintly clustered and spreading without restraint; for mild toxicity, Guizong Tang (Return to Ancestral Decoction) regulates the treatment, while for severe toxicity, Bisheng Tang (Invincible Victory Decoction) combined with Pig Tail Paste is suitable.
[Note] When pustules emerge in clusters forming patches, scattered and unrestrained, it is named "Snake Skin" (Shepi). At the initial appearance stage, observing them as faintly clustered and extremely dense indicates they are caused by toxic fire. Use Guizong Tang (Return to Ancestral Decoction) to attack the toxin; in severe cases, use Bisheng Tang (Invincible Victory Decoction) assisted by Pig Tail Paste for rescue.